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Beyond the : Clinician Educational Interventions May Not Be Enough to Decrease Rates of Low-Value Spinal Imaging.
AJR Am J Roentgenol
January 2025
Assistant Professor, Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center.
Supplemental Oxygen Use, Outcomes, and Spending in Patients With COPD in the Medicare Competitive Bidding Program.
JAMA Intern Med
December 2024
Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle.
Importance: The Medicare Competitive Bidding Program (CBP), a policy that reduced durable medical equipment prices, was implemented starting in 2011. Legislation introduced in 2024 aims to remove supplemental oxygen from the CBP because of concerns that recent decreases in oxygen prescribing are due to lower prices set by the CBP, which may have decreased supply and, in turn, limited oxygen access for patients with chronic lung diseases. However, low-value prescribing of oxygen is also prevalent in practice, and decreased oxygen prescription rates may not have necessarily caused harm.
View Article and Find Full Text PDFPartnering With Patients and Families to Champion Deimplementation and Reduce Low-Value Care.
Hosp Pediatr
October 2024
The Hospital for Sick Children, Toronto, Ontario, Canada.
Electronic Health Record-Based Nudge Intervention and Axillary Surgery in Older Women With Breast Cancer: A Nonrandomized Controlled Trial.
JAMA Surg
October 2024
Women's Cancer Research Center, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.
Importance: Choosing Wisely recommendations advocate against routine use of axillary staging in older women with early-stage, clinically node-negative (cN0), hormone receptor-positive (HR+), and HER2-negative breast cancer. However, rates of sentinel lymph node biopsy (SLNB) in this population remain persistently high.
Objective: To evaluate whether an electronic health record (EHR)-based nudge intervention targeting surgeons in their first outpatient visit with patients meeting Choosing Wisely criteria decreases rates of SLNB.
PERSPECTIVE: A Path to Value-Based Insurance Design for Mental Health Services.
J Ment Health Policy Econ
March 2024
Division of Services and Intervention Research; National Institute of Mental Health; 6001 Executive Boulevard, Bethesda, MD 20892, USA,
Background: Aligning cost of mental health care with expected clinical and functional benefits of that care would incentivize the delivery of high value treatments and services. In turn, ineffective or untested care could still be offered but at costs high enough to offset the delivery of high value care.
Aims: The authors comment on Benson and Fendrick's paper on Value-Based Insurance Design (VBID) for mental health in the September 2023 special issue of this journal.
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